"Wilson's is just one of thousands of cases to argue against their near-religious views."

It's still a little early for any conclusions yet... if he was taking heroin or coke or whatever it probably played into the attempt. If he had just started a regimen of anti-depresents and was clean otherwise some of the early -- but rare -- side effects can lead to suicidal thoughts... but we sholdn't be rushing to allow pharmaceutical spokespeople and Entertainment Tonight take the place of Owen, his family and his doctors. Owen Wilson's "case" can't argue in favour or against anything right now.

It still shocks me that people with a history of drug addiction are given psych drugs at all.

Sally, you bring up a good point re: street drugs vs. psych meds. Sometimes they end up being abused the same way. Adderall, Ritalin and now Seroquel are a few examples.

I completely agree that giving psych drugs to people who have been addicted to cocaine or heroin is like going from the frying pan into the fire -- absolutely crazy -- and if Owen was at Hazelden even if it was 7 years ago that is their treatment protocol from what I understand. I feel pretty sorry for anyone who's put on this path from illegal to legal drug dependency.

On the stigma front, I wonder if Wilson will face trouble getting roles because of insurance issues faced after a publicized suicide attempt?

In graduate school we were repeatedly taught that after initiating treatment with antidepressants, risk for suicide increases during the early going for some patients. I was surprised to learn years down the road that this was no longer accepted wisdom. It was the prevailing view at one time and I believe it is correct.

As for initiating psych meds to recovering addicts, it depends entirely on the medications and a comprehensive assessment of the individual patient. Benzodiazapenes are highly risky, but to equate SSRI "dependence" with addiction sounds more like an ideological objection than experience with addicts on medication.

I tend to be on the very conservative side about psychiatric medications, but to reject antidepressants out of hand because someone is recovering addict is unwarranted. The risks of pharmacological treatments versus foregoing such treatment should be carefully assessed and mutually decided by a well-informed patient and doctor. That last part is key and one of the most troubling things about the way medication is often prescribed - without concern for the patient's understanding and without attentiveness to effectiveness and side effects reported by the patient.

I guess it is hard to understand how an antidepressant would help a recovering addict. You're not teaching the person how to deal with life on life's terms but instead how to substitute one drug for another. I think science would reflect my theory that ssris are at least as addictive as most street drugs but realize that this is a radical opinion. Think if you will about the albeit overblown and sensationalized study that reported that marijuana causes psychosis. I speculate that the proven accounts of ssri's causing psychosis occur at a much greater incidence than marijuana is reported to and of course unlike ssri's marijauna has never been shown to cause suicide or violence. You admit the benzos are bad for the long term, I suggest SSRIs are probably just as bad.

The risk for suicide increases, for sure, in many patients and in some cases it's de novo suicidal ideation, that is, suicidality can occur for the first time after commencement of treatment even in so called healthy volunteers. The phenonenon which should be rejected in the case of SSRIs is the "energizing" phenomenon where someone with pre-existing suicidal impulses somehow gets the energy and the will to carry through -- this is not what happens on antidepressants. Rather it's an activation of violent, bizarre and out of character ideation that is completely different than any thought processes that occurred before treatment. It's often dose related. I've seen this firsthand and also had it described to me countless times. This is not something I think you want someone who's been addicted to street drugs to experience IMHO. As for being "attentive" to the patient this is all very well and good but I have seen these impulses come up extremely quickly and unexpectedly; some of the behavior that occurs on antidepressants is extremely unpredictable and can occur in the middle of the night because it's probably related to some disruption of REM sleep. It is utterly frightening and horrific. Medical professionals should not be so naive as to expect they can protect against this in every patient. It's not possible.

From a personal perspective, the only time I stood on a roof of a car in pouring rain screaming I want to kill myself[and meant it] was when I was loaded up on Prozac. It's a different suicidal feeling when it is chemically induced. I don't feel that way when "typically" depressed.On the Prozac I was out of control, and am grateful I am alive to discuss it.
-Owen has the front cover of PEOPLE today, as we all expected.

-JAMA current issue inside flap is a full page of Cymbalta ad.[I like the reading table I've got access to these days].The JAMA is loaded with pharma advertising.
-Dr.X makes an excellent point re: the need for patients/doctors to be informed and well versed before making a medication decision. I have yet to have EVER been given any information I needed to know re: any psych med given to me via PCP or the psychiatrist. I am grateful to myself that I know what I do, though that still wasn't enough when I suffered on Seroquel and Prozac. Those were the worst, and I'm glad I never did Cymbalta or Effexor.[just my opinion]. Lamictal has given me a certain clarity that I never had before, and it's still up for grabs as to whether or not it's me or the med giving me that clarity.[working on it].

Face it anything we do such as meth, pot, psych meds, etc. all are going to do something to our brain.

In 1986 while researching for a paper, I discovered the Journal of the American Psychiatric Association. My mother had a wicked addiction to Valium so I was shocked to see the full page "Valium Drug of Distinction" ad in the APA Journal after so much public education on the dangers of the drug. And then there was the ad I talked about for years that was featured a full page photograph of a young man dressed in rags standing outside of a hospital emergency room with the caption, "72 hours ago he was out of control, now he's manageable." The ad implied that the guy had been doped up and kicked out the door of the hospital. I always wondered how terrifying and dangerous it must be to be "manageable." 10 years later a phrink prescribed zoloft to me for according to my chart "anxiety issues." I had just been transfered to a new city where I didn't know anyone and was terribly lonely. When I asked her what zoloft was, she recommended that I read "Listening to Prozac," which I did. In that book, it was explained that taking SSRIs was like having a drink or two, it gave the user a social advantage. So I thought, hmmm odorless alcohol that gives you a buzz without intoxicating you, not a bad idea but somewhat dishonest and very dangerous. I asked the phrink how long I would have to take zoloft and she said, forever. I then asked her what it was made of, and of course she thought that was an odd question and asked why I wanted to know. If I'm going to need it for the rest of my life, I guess I'm hoping the raw materials to make it don't run out. Of course when I left that job and health insurance she stopped prescibing it and I was fine without it. I've often wondered how any doctor, having read Listening to Prozac, could prescribe any SSRI.

Owen Wilson is an admirable actor. I understand that he was involved with Kate Hudson and following the end of this relationship he plunged into a depressive state.

Suicide was the eighth leading cause of death for males and the sixteenth leading cause of death for females in 2004.

I believe that on occasion, men in general find it extremely difficult to vent their emotions and thereby obtain the support they require. Society tends to give them the message that they should be tough guys. Indeed, Owen possibly finds it incredibly difficult not to live up to the persona built in the public.

Whatever anti-depressants he was on, one cannot avoid the reactive factors involved in this attempt. The important issue here I hope he should understand that - nothing is worth ending one's life. Besides, I believe patients often do not understand that attempts to end one's life may simply result in disability. That is an important concept to grasp.

How many assessments have I made where the patient did not forsee the fact that in many cases death is not the result but brain damage is. Most tell me " I wish someone had told me that before".

Owen Wilson is one of my favourite actors. He is charming and wonderful as a person and a man.
I suspect he needs to believe that himself and he also should understand that life is to be lived and it is too precious to be taken away on a whim. While Kate Hudson may not have worked out for him - one relationship will be made in heaven and that is worth waiting for.

In my view, all patients/public who meet at the edge of despair should remember that heaven can wait. Life though is important to cherish because you only have one go at it.

Dr Rita Pal
www.nhsexposed.com
www.nhsexposedblog.blogspot.com